Salary Data

Medical Grievance and Appeals Nurse Salary

How much does a Medical Grievance and Appeals Nurse make in the United States?
Get the insights on the salary, benefits, education, and job description.
Salary Data for Medical Grievance and Appeals Nurse

$84,210 (USD)/yr

$40 (USD)/hr

$1,474 (USD)/yr

$83,084 (USD)/yr

$40 (USD)/hr

$1,474 (USD)/yr

Job Description
Evaluates and resolves clinical appeals, grievances, and external reviews received from members or providers, including review of pre-service and post-service appeals, utilizing understanding of clinical department operations and claims processing procedures. Communicates and interacts with external partners, including providers, medical groups, Independent Practice Associations, and other external vendors. Reviews medical records related to grievances and appeals, provides monitoring of cases involving medical decisions and quality or care or service, and prepares and performs clinical reviews. Logs grievances and appeals; obtains medical records as needed; and provides clinical reviews, write-ups, and recommendations. Develops correspondence communicating acknowledgement and resolution to enrollees and providers, following appeal time frames. Requires RN license.
The average medical grievance and appeals nurse salary in United States is $84,210 or an equivalent hourly rate of $40. In addition, they earn an average bonus of $1,474. Salary estimates based on salary survey data collected directly from employers and anonymous employees in United States.
Compensation Data Based on Experience

$58,768 (USD)

$104,687 (USD)

Education data not available for this job

Are you paid fairly?

Calculate your market salary rate to find out
Calculate Salary

Do you work in HR or Compensation?

Try a Free Demo

Try our professional compensation software to generate detailed salary and cost of living reports.

Try a FREE Demo
Salary Potential

$97,622 (USD)

16 %

Based on our compensation data, the estimated salary potential for Medical Grievance and Appeals Nurse will increase 16 % over 5 years.

Jobs That May Interest You
Registered Nurse-Medical Appeals/Grievance Specialist (prior UM/Claims experience preferred)
access_time Posted 1 month ago
account_balance Blue Cross Blue Shield of Arizona
location_on Phoenix
Job Details Job Title Registered Nurse-Medical Appeals/Grievance Specialist (prior UM/Claims experience preferred) Job ID 4182 Location Phoenix Full/Part Time Full-Time Favorite Job Regular/Temporary ...
Appeals Nurse ( RN )
access_time Posted 9 days ago
account_balance Healthcare Support
location_on Woodland Hills
Benefits offered, Medical, Dental, and Vision * Fun and positive work environment Interested in being Considered for this Appeals and Grievances RN Opportunity? If you are a Registered Nurse and are ...
Appeals and Grievance ,QI Nurse, Medical Management-FT Day (8hr)
access_time Posted 1 month ago
account_balance MemorialCare Medical Foundation
location_on Fountain Valley
Quality Nurse Employee ID: Job Code: F-2021 Department: Medical Management Dept. Number: 875000 ... times for preservice appeals, grievances and denial letters. Essential Functions and ...
RN Case manager . Exp with Appeals /Denials Nurse
access_time Posted 9 days ago
account_balance Xpert Recruiters LLC
location_on Los Angeles
Support the Quality Improvement Program, including proper management of grievances, appeals ... In addition, the Quality Improvement Nurse supports other QI activities related to HEDIS, medical ...
Nurse Supervisor LVN or RN
access_time Posted 9 days ago
account_balance Medical Professionals
location_on Northridge
Progressive prior-authorization, appeals & grievance, health plan oversight or health plan ... plan, medical group, IPA or management company required. * Experience supervising staff and ...

Are you an Employer?

Determine the Market Salary Range for Any Position
Try a Free Demo
About The Data
The above data is a sample of data available in ERI's Global Salary Calculator. The Global Salary Calculator provides compensation data for over 45,000 positions in 8,000+ cities in 69 countries. If you need to calculate competitive levels of salaries, incentives and total compensation by industry, organization size and salary planning date, please view a demonstration version of ERI's Salary Assessor, which is used by the majority of the Fortune 500 for salary survey data and compensation planning.

Get a FREE Salary Report

Add up your past jobs, education, and experience and find your market rate